Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09660 | Date 29/07/2025 |
| Token No | SM/25-26/5505 29/07/2025 | Serial | 003 |
| Patient Name | Mrs. ALO SARKAR | Contact No | 6290944843 |
| Address | 79 A/M AMULYA KANNAN SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||